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NII forms for submitting a claim for benefit and for matters of insurance and collection of insurance contributions.
The forms are in PDF format. For viewing or printing them you need Acrobat Reader, available for free on the internet. To download Acrobat Reader and for guidelines, click here.
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| 5400 - Payment Under the Maintenance Law |  Claim for women with alimony verdict in hand, requesting the payments directly from the NII since the person who owes her the alimony is not paying her directly. The form is to be personally submitted at the local branch together with the necessary documents. |
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| 5015 - Study Grant |  The form is for parents who are divorced, single or widowed, separated, Agunah, and a new immigrant who has been in Israel for one to two years. |
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| 68 - Adding/Deleting Users |  This form is for people in the client representation system on the internet - to add/delete office employees as users of the system (this form has to be filed with the addendum of confidentiality NII/66). |
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| 69 - Canceling Representation |  This form is for representatives, accountants or tax consultants who would like to inform the NII that they are canceling representation of clients. |
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| 631 - Request for deposition of Joint Property |  The form is for married or common-law couples, requesting to share income not from work (renting a property for a business, home, etc.). The sharing will be enabled based on their statement and under the rules determined by the NII. |
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| 1050 – Registration questionnaire | 
The form is to be filled out by persons who have a 2A visa, or a 4A visa as persons accompanying those with a 2A visa, and who wish to be recognized as residents by the National Insurance Institute (subject to completing a waiting period). |
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| 6102 – Detailed annual report | 
The form is to be filled out by persons who have a residency visa, including A5, and who the National Insurance Institute has requested to fill out this form.
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| 6124 – Order to debit an account by means of credit card |  The form is meant for payment of current national insurance contributions by means of credit card. The form should be filled out and transferred to the collection department in the local NII branch closest to one's place of residence.
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| 6127 - Direct Debit Order Authorization Form |  For collection only. NII is happy to offer you a more convenient way to pay insurance contributions: a standing order at the bank. The payments will be deducted from your account at the date determined by law. The NII commits itself to collect only the monthly payments with the automatic charge, and no other debts. If you choose this arrangement, please fill in the form and submit it to the local branch in which your account is managed. |
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| 6978 - Direct Debit Order and Standing Order Agreement |  Authorization form for charging an account, used by the employers represented by a person connected to the client representation system of the NII for regular payments and for the use of the employer to carry out a standing order payment agreement. |
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| 627 - Questionnaire for determining residency of persons living abroad |  This questionnaire is for employees who notify the NII that they will be going abroad due to being sent to work abroad on behalf of an Israeli employer, and whose work contract was signed in Israel(including local Israeli employees). Those leaving the country for any other reason must report this to the NII local branch in person. |
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| 2600 - Claim for Long-term Care Benefit |  Claim form for elderly people of old age living at home who need the assistance of others in performing everyday functions. Those eligible for the benefit will receive long-term care services and not a cash benefit. |
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| 330 - Risk Pregnancy Benefit Payment Claim |  This form is for women who cease work due to the need for precautionary rest as a result of a risk pregnancy, in accordance with medical authorization of a gynecologist. In order to be eligible for payment, the risk pregnancy must be of at least 30 consecutive days and there is no eligibility for payment for risk pregnancy from any other source. |
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| Form | Order | Download |
| Claim for Special Grant to Work Disabled - 266 |  A work-disabled person with a 65% medical disability in his legs or a total 75% permanent medical disability may be eligible, under certain conditions, for a grant to adapt his living conditions, for accessories and for a vehicle. |
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| 271 - Application for an Advance/Loan/Conditioned Grant |  A work injured person may, in certain circumstances, be eligible for an advance payment on his monthly pension in order to begin rehabilitation. Under Regulation 113 of the National Insurance Law, the NII may authorize capitalization for various purposes if it is proven that the claimant has a permanent income sufficient for his subsistence or a reasonable chance of such an income. |
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| 1521 - Payment Claim for the Grant |  Application for payment of the grant to discharged soldiers who worked in a preferred/required job and girls who served two years in the voluntary National Service. |
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